National Provider Identifier [NPI]: |
1518911064 |
Last Name Of The Provider |
GOPAL |
First Name Of The Provider |
DEEPAK |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
451 JUNCTION RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
537172656 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
813 |
Number Of Medicare Beneficiaries |
412 |
Total Submitted Charge Amount |
1127222.5 |
Total Medicare Allowed Amount |
134761.99 |
Total Medicare Payment Amount |
103825.78 |
Total Medicare Standardized Payment Amount |
110255.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
77 |
Number Of Medical Services |
813 |
Number Of Medicare Beneficiaries With Medical Services |
412 |
Total Medical Submitted Charge Amount |
1127222.5 |
Total Medical Medicare Allowed Amount |
134761.99 |
Total Medical Medicare Payment Amount |
103825.78 |
Total Medical Medicare Standardized Payment Amount |
110255.8 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
77 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
212 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
378 |
Number Of Black or African American Beneficiaries |
12 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
334 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
78 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.6452 |